Antidiabetic Medication and Asthma Attacks
Authors' conclusion
The results of this cohort study suggest that metformin was associated with a lower rate of asthma attacks, with further reductions with the use of GLP-1RA. This appeared to be associated with mechanisms other than through glycemic control or weight loss and occurred across asthma phenotypes.
Study context
- Population
- New users of metformin with T2D and asthma, UK Clinical Practice Research Datalink (CPRD) Aurum linked hospital admissions and mortality data, 2004–20204,278 self-controlled case series (SCCS)
- Exposure
- Metformin exposure vs unexposed
- Outcome
- First asthma exacerbation (short course of oral corticosteroids, unscheduled asthma-related hospital attendance, or death)
- Follow-up
- 12-month follow-up
Methodological detailstriangulation approach, self-controlled case series (SCCS), metformin new user cohort with inverse probability of treatment weighting (IPTW), negative control analyses
- Triangulation approach
- Self-controlled case series (SCCS)
- Metformin new user cohort with inverse probability of treatment weighting (IPTW)
- Negative control analyses
Main finding
As reported in the abstract
Asthma attacks
Estimate (95% CI)
Between Exposed and Unexposed
IRR (SCCS) 0.68(0.62–0.75)
Between Exposed and Unexposed
HR (IPTW) 0.76(0.67–0.85)
Observational data: associations, not effects.
Further findings
Add-on GLP-1 RA, additive association with asthma attacks
- GLP-1 RA, SCCS IRR (95% CI 0.49-0.73); only add-on with additive association
- 0.60
Effect modification
- HbA1c, body mass index (BMI), blood eosinophil counts and asthma severity did not modify the association
Negative control analyses
- No evidence of significant bias
Original publication
Antidiabetic Medication and Asthma Attacks. JAMA Intern Med. Published 1 January 2025. doi:10.
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